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No. 61 



THE RELATION OF PHYSICAL DEFECTS 
TO SCHOOL PROGRESS 



LEONARD P. AYRES 

ASSOCIATE DIRECTOR, DEPARTMENT OF CHILD HYGIENE, RUSSELL SAGE FOUNDATION 



REPRINTED FROM 

THE ELEVENTH ANNUAL REPORT OF THE CITY 
SUPERINTENDENT OF SCHOOLS, NEW YORK CITY, 1909 



Department of Child Hygiene 

Russell Sage Foundation 
i Madison Avenue, New York City 



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The Relation of Physical Defects" to School 

Progress 



In a study of retardation in the New York public schools con- 
ducted last year a careful tabulation was made of the records of 
the physical examinations of 7,608 children who had been ex- 
amined by school physicians. When these records were tabu- 
lated the astonishing condition was brought to light that nearly 
80 per cent of the children who were of normal age for their grades 
were found to have physical defects, while only about 75 per 
cent of the retarded children were defective. 

Another noteworthy point was that the percentage of de- 
fective children in the lower grades was decidedly greater than 
in the upper grades. The discovery of these unlooked-for re- 
sults led to further study of the figures. The data were retabu- 
lated by ages, and the results showed a very marked and con- 
sistent falling off of children having each sort of defect from the 
age of six up to the age of fifteen. Defective vision alone in- 
creases slowly but steadily with advancing age. 

Moreover, these decreases were not due to the falling out or 
leaving school of children suffering from defects. This might 
be put forward as an explanation if we had to do with children 
above the age of compulsory attendance, or if the characteristic 
decrease did not take place until the age of fourteen or fifteen; 
but such is not the case. The children were of from six to fifteen 
years of age, and the marked increase began with the seven, 
eight, nine and ten year old children and continued steadily. 

Were further data not available, it would certainly be difficult 
to explain the seeming anomaly that retarded children have 
fewer defects than do children of normal age ; but the data show- 
ing the decrease of physical defects with increasing age are 
illuminating. It is evident that here age is the important factor. 
The importance of this on all investigations into the influence 
of physical defects on school progress is at once evident. 

3 



Whether the term "retarded" is used to express a condition 
or an explanation, it will always follow from the definition itself 
that retarded children will be older than their fellow pupils in 
the same grades. In all cases it will always be true that the 
"backward" pupils will be the older pupils. Now, the older 
pupils are found to have fewer defects. This is true whether 
they are behind their grades or well up in their studies. There- 
fore, it is not surprising that we find 80 per cent of all children 
of normal age have physical defects more or less serious, while 
75 per cent of the retarded children are found to be defective. 
This does not mean that pupils with more physical defects are 
brighter mentally. It simply means that those who are above 
normal age are older, and that older pupils have fewer defects. 

In order to ascertain what correlation may exist between 
physical defects and school progress, the records of the children 
have recently been retabulated, using as a basis age instead of 
grade, so that the results should not be vitiated by the hetero- 
geneous age composition of the grades. 

The children were arbitrarily divided into dull, normal and 
bright groups using, as a standard, age in grade. For instance, 
it was considered that the eleven year old child in the first grade 
may as a rule be safely classed as dull, whereas the ten year old 
child in the sixth or seventh grade may safely be considered 
bright. Using the age in grade criterion as a basis the records 
of the ten, eleven, twelve, thirteen and fourteen year old children 
were retabulated and assigned to the dull, normal and bright 
classes. Results are shown in the following table: 



Per Cent of Dull, Normal and Bright Pupils Suffering from Each 

Sort of Defect. Ages Ten to Fourteen, Inclusive. 

All Grades 



Enlarged glands 

Defective vision 

Defective breathing. . 

Defective teeth 

Hypertrophied tonsils 
Adenoids 



Dull 


Normal 


20 


13 


24 


25 


15 


1 1 


42 


40 


26 


T9 


IS 


10 


— 





Bright 



6 
29 



34 



Here we have for the first time figures which conclusively 
demonstrate that there is a real relation between physical de- 



s 

fectiveness and school progress. In each case, save that of 
vision, a larger percent of the dull pupils is found to be defective 
than is the case among the normal pupils, and these again are 
more defective than the bright pupils. The fact that defective 
vision does not follow this same rule is somewhat difficult of 
explanation. There can be no question that seriously defective 
vision constitutes a real handicap to the progress of the child. 
On the other hand it has long been a matter of common observa- 
tion that the brightest and most studious pupils are often afflicted 
with defective eyesight. It may very well be that these two 
factors somewhat more than counter-balance each other. That 
is to say, while defective vision is undoubtedly a real handicap 
and is the cause of backwardness among some children, there are 
found in these same classes unusually bright children who have 
so injured their eyesight through undue strain and use that they 
too have very defective vision. This explanation cannot be 
put forward as conclusive for there is no data to substantiate it. 
It seems, however, a reasonable explanation and one which co- 
incides with the known facts in the case. 

The results shown in the foregoing table show plainly enough 
that there is a distinct relation between progress and physical 
defects. They do not, however, show what the relation is in 
terms of any given units. They do not show how many more 
grades are completed by the non-defective than by the defective 
child. In order to arrive at such a measure new computations 
were made showing the average number of grades completed by 
the ten year old pupils, by the eleven year old pupils, and so on 
for each of the other ages. The central tendency of all of these 
sets of results was then computed. The results are shown in the 
following table and diagram: 

Average Number of Grades Completed by Pupils Having No Phys- 
ical Defects Compared with Number Completed by Those Suf- 
fering from Different Defects. Central Tendency 
Among 3,304 Children, Ages Ten to Fourteen 
Years, in Grades One to Eight 

Average Number 
of Grades 



Children having no physical defects. . . 

Children having defective vision 

Children having defective teeth 

Children having defective breathing. . . 
Children having hypertrophied tonsils. 

Children having adenoids 

Children having enlarged glands 



11 


LETED 


4-94 


4 
4 
4 


94 
65 
58 


4 


5° 


4 


24 


4 


20 



Scale of Grades 

± 1 5 1 




No defects - k.$k grades 
Defective vision - 4-,9^ grades 
Defective teeth - ^.65 grades 
Defective breathing - k.5$ grades 



Hvpertrophied tonsils - 

4.50 grades 

Adenoids - k.2k grades 



Enlarged glands - ^.20 grades 



Diagram Showing Average Number of Grades Completed by 
Pupils Having No Physical Defects Compared with the Number 
Completed by Those Suffering from Different Defects 



The notable feature of the table is the fact that in every case, 
except that of defective vision, the children suffering from each 
sort of physical defect made less progress in their school work 
than did those not so handicapped. The seriousness of these 
handicaps in terms of percentages is shown in the next table: 

Table Showing the Extent to Which Children Suffering from 

Each Sort of Physical Defect Progress More Slowly 

Than do Children with No Defects 

Per Cent of 
Kinds op Defects Loss in Progress 

Defective vision 

Defective teeth 6 

Defective breathing 7 

Hypertrophied tonsils 9 

Adenoids 14 

Enlarged glands 15 

Average 9 

In this table the average loss of per cent which appears in the 
last line is not, of course, the numerical average of the percentages 
of loss corresponding to the different sorts of defects, but rather 
the general loss of progress discovered among all the children 
having physical defects. In other words, the children suffering 



from physical defects made on the whole 9 per cent less progress 
than did those having no physical defects. 

In order to show more definitely in terms of school progress 
just what these handicaps mean we may apply them to the cases 
of supposititious non-defective and defective children. If we 
assume that the average child without physical defects of any 
kind will complete the eight grades in just eight years, how long 
will it take defective children to complete eight grades? The 
answer to this question may be found in the following table 
and diagram: 

Number of Years Necessary for Defective and Non-defective 
Children to Complete the Eight Grades 

Time for 
Kinds of Defects Eight Grades 

No defects 8 years 

Defective vision 8 years 

Defective teeth 8.5 years 

Defective breathing 8.6 years 

Hypertrophied tonsils 8.7 years 

Adenoids 9.1 years 

Enlarged glands 9.2 years 



Scale of Oradee 

£—3 — k — 5 — 6- 



4-4 



Ho defects - t years 
Defective vision - f$ years 
Defective teeth - g.5 years 
Defective breathing - g.6 years 



Hypertrophied tonsils - 6. 7 years | I I I 
Adenoids -9-1 years 



□ 



Enlarged glands 



9.2 years 



Diagram Showing Number of Years Required by Defective and 
Non-defective Children to Complete the Eight Grades 



If these figures are substantially significant for all of New York 
City school children, their educational and economic import is 
great. According to the data, the child with seriously defective 



teeth requires half a year more than a non-defective child to 
complete the eight grades. About one-half of the children have 
seriously defective teeth. The handicap imposed by defective 
breathing means six-tenths of a year. About one child in 
seven has defective breathing. The child with hypertrophied 
tonsils takes about seven-tenths of a year more than he should. 
About one child in every four has hypertrophied tonsils. The 
extra time required by the child with adenoids is about one and 
one-tenth years. About one child in eight has adenoids. The 
pupil with enlarged glands requires one and two-tenths years 
extra. Nearly half of the children have enlarged glands. 

The sums of money spent annually by New York City for 
public education reach high into the millions. It would be a 
very simple matter to compute how many dollars are wasted 
each year in the futile attempt to impart instruction to pupils 
whose mental faculties are dulled through perfectly remediable 
physical defects. Roughly speaking, about sixty per cent of all 
the children suffer from such defects. If, then, we should show 
that the instruction given these children suffers a loss in effective- 
ness of nearly ten per cent because of remediable physical de- 
fects, it is at once evident that the direct financial bearing of the 
problem is of great significance. 

Such a computation, while it would undoubtedly prove in- 
teresting, is perhaps better left unmade because we do not know 
that the data discussed are either truly reliable or generally 
representative. They are a comparatively small number of 
cases in one city, in one year, and could similar data be secured for 
longer periods of time and in more localities it is not only possible 
but most probable that they would show different results. 

The examination is important because it establishes the prin- 
ciple that, except in the case of vision, older children have fewer 
defects. It shows that when children who are badly retarded 
are compared with normal and very bright children in the same 
age groups the children rated as "dull" are found to have higher 
percentages of each sort of defect than the normal and bright 
children. In this generalization defective vision must be ex- 
cepted. 

Moreover, the investigation gives us quantitative measures 
of the retarding forces of the different kinds of defects. In 
general, children suffering from physical defects are found to 
make about nine per cent less progress than do children having 



no physical defects. The figures do not really show the retarding 
influence of each sort of defect separately for the reason that the 
same child is often suffering from several sorts of defects. 

Because of the reasons that have been mentioned, the figures 
may be accepted as having distinct value in revealing general 
tendencies, but must not be interpreted as showing with exact 
precision the relative, retarding force of each separate sort of 
defect, or even of physical defectiveness in general. 



Russell Sage Foundation Publications 



MEDICAL INSPECTION OF SCHOOLS 

BY LUTHER HALSEY GULICK, M. D. 

Director of Physical Training of the New York Public Schools; and 

LEONARD P. AYRES, A. M. 

Formerly General Superintendent of Schools for Porto Rico 

Some Opinions 

"Lucidly exhaustive and admirably arranged." — The Nation. 

"A notable contribution both to medicine and to school administration." — 
Erie Dispatch. 

"Of large practical utility." — Rochester Times. 

"The book is most complete and valuable." — 5. W. Newmayer, M. D. 

"An important contribution to the cause of Education." — Journal of Education. 

"The appearance of this most timely book is cause for genuine satisfaction." — 
Charities and the Commons. 

Third Edition. Price postpaid, $1.00 



LAGGARDS IN OUR SCHOOLS 

A Study of Retardation and Elimination in City School Systems 
BY LEONARD P. AYRES, A. M. 

Formerly General Superintendent of Schools for Porto Rico and Chief of the 
Division of Statistics of the Insular Department of Education, Secretary 
of the Backward Children Investigation of the Russell Sage Founda- 
tion. Co-Author of Medical Inspection of Schools, etc. 

"I shall use it in my course in child psychology in the University of Pennsylvania 
next winter and expect to make it the basis of the statistical side of the work for 
some years to come." — Lightner Witmer, Professor of Psychology, University of 
Pennsylvania. 

"The work is marked by logical sanity and absence of the hasty and extravagant 
generalization that one so often finds in sociological discussions." — Borden P. 
Bowne, Dean of the Graduate School, Boston University. 

"I have read the book with increasing satisfaction, and shall have still more 
satisfaction in using it in my classes during the coming year as an illustration of 
what an investigation in school administration really means." — Paul H. Hanus, 
Director Division of Education, Harvard University. • 

"Mr. Ayres has given life to his figures and character to his diagrams."— 
American Industries. 

"Such a book, at once readable and scholarly, scientific and popular, critical 
and constructive, is typical of the best in educational literature." — The Independent. 

"It is the most important specific study of school conditions that has been made 
by any one." — Journal of Education. 

Second Edition. Price postpaid, $1.50 



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